Ask the Pediatrician
Q1: My child is extremely afraid of the dark and cannot go to sleep unless a light or music is on. What can I do to help him overcome this fear?
Being afraid of the dark is a very common fear for children. Even older teens can retain a fear of the dark for a number of reasons. For children, the “dark” also represents all those things that don’t make sense about the world. Some children have had a fearful experience in the past and still need to emotionally and psychologically work through it, whether the event happened at night or not. Some do not like the separation at night and feel much more vulnerable when alone. These reasons and many more are all variations of being “afraid of the dark.”
While very common, children are generally amenable to interventions by parents. If your child can vocalize what causes the fear, talking through it is a good way to begin. Acknowledging the fear as real in your child’s mind is also important, otherwise he or she may have to “prove” the fear is really there. Spending time at bedtime reading stories and doing a quick room check for “monsters” is frequently a helpful approach. Exposure to disturbing images on the news, in movies, or in video games may need to be minimized to help your child have fewer fears going forward.
Finally, if your child has significant and persistent fears, to the point where it is interfering with sleep and/or otherwise normal functioning, then consulting with your clinician and/or a psychologist may be needed to change their current thought patterns.
Q2: We just had our first child and are concerned that she has colic. She cries for what seems like hours a day, and we’re to the point where we think we are doing something terribly wrong as parents. Can you help?
Crying is a very normal part of an infant’s behavior in the first several months. One of the biggest challenges, especially with first-time parents, is to not think you are doing some thing wrong in the way that you are caring for your baby. The average two month old cries about three hours per day, usually in the evening. Anything above that is typically considered excessive, but is still likely normal for your baby. If it is considerably more than three hours per day, especially if it is all hours of the day or night, then your baby may have a medical condition that needs evaluation.
If you are in the “two to three hours of crying in the evening” phase, there are a number of things you can try to help reduce the amount of time your baby is crying. It is generally helpful to use a sequence of interventions to soothe distress. Try feeding her: even if it was a short time ago, she may still be hungry. If that is not helpful, try walking with your baby, gently patting her on the back and talking softly or singing to her. If she hasn’t settled down after 10 to 15 minutes, it is not likely to help. Next, try sitting in a rocking chair. Lay her tummy-side down on your lap as you gently rock, and rub her on her back. Again, if that has not worked after 10 to 15 minutes, try slowly bicycling her legs while she is on her back—this can be helpful to soothe any intestinal gas issues. Finally, if all else fails, put her in her crib and let her try falling asleep for 10 to 15 minutes. If this is not successful, start the sequence again and you will likely find a way to reduce her crying. This method has actually been confirmed to be helpful in studies on babies and colicky behavior.
If your infant is crying more than what you feel comfortable with, please consult your baby’s clinician. There are situations where crying does indicate a treatable medical condition and needs to be thoroughly assessed.
Q3: With all the talk of obesity, should I be worried that my baby is overweight? Should I restrict his calories to make sure he does not become an overweight preschooler?
While childhood obesity is a major concern and can have significant lifelong implications, this really becomes much more of a concern after age two. Brain growth and overall developmental advances are critical during the first two years and parents should not be concerned with excessive growth during this time. Infants basically triple their weight in the first year of life and you should not try to restrict calories in any way. It is also important that 18- to 24-month olds have a lot of large motor play opportunities and should not be overly restricted in their aerobic activities, such as being stationed in front of a TV for hours each day. They should also have a diet that contains more fruits and vegetables while staying away from sugar sweetened beverages, including many fruit juices.
While it is extremely uncommon, excessive weight gain in the first 12 to 18 months can happen. If it does, there is generally an underlying medical cause. If you are concerned about your infant’s or young toddler’s weight gain, please consult your health care professional.
This column is intended to provide general information only and not medical advice. Contact your health care provider with questions about your child. Dr. Peter Dehnel is a board-certified pediatrician and medical director with Blue Cross Blue Shield of Minnesota. Send questions to firstname.lastname@example.org.